We study insurers' use of prescription drug formularies to screen consumers in the ACA Health Insurance exchanges. We begin by showing that exchange risk adjustment and reinsurance succeed in neutralizing selection incentives for most, but not all, consumer types. A minority of consumers, identifiable by demand for particular classes of prescription drugs, are predictably unprofitable. We then show that contract features relating to these drugs are distorted in a manner consistent with multidimensional screening. The empirical findings support a long theoretical literature examining how insurance contracts offered in equilibrium can fail to optimally trade off risk protection and moral hazard.
Over the past two decades, the U.S. federal government has sought to increase its capacity to find, apprehend, and deport noncitizens residing in the United States who have violated federal immigration laws. One way the federal government has done this is by partnering with state and local law enforcement agencies on immigration enforcement efforts. The present study analyzes the records of all 1,964,756 interior removals between fiscal years 2003 and 2015 to examine how, if at all, the types of criminal convictions leading to removal from the U.S. interior have changed during this period of heightened coordination between law enforcement agencies and whether there are differences by gender and region of origin in the types of convictions leading to removal. Findings show that as coordination between law enforcement agencies intensified, the proportion of individuals removed from the U.S. interior with either no criminal convictions or with a driving-related conviction as their most serious conviction increased. Findings also show that the proportion of individuals removed with no criminal convictions was greater for women than for men and that the share of individuals removed with a driving-related conviction as their most serious conviction was greater for Latin Americans than for individuals from all other regions. Given renewed investment in these types of law enforcement partnerships under the Trump administration, the patterns presented in this article may foreshadow trends to come.
In August 2005, Hurricane Katrina caused unprecedented damage, widespread population displacement, and exposed Gulf Coast residents to traumatic events. The hurricane's adverse impact on survivors' mental health was apparent shortly after the storm and persisted, but no study has examined the long-term effects now that more than a decade has transpired. Using new data from a panel study of low-income mothers interviewed once before Hurricane Katrina and now three times after, we document changes in mental health, and estimate the sociodemographic and hurricane-related factors associated with long-term trajectories of mental health. We find that post-traumatic stress symptoms (PTSS) declined at each of the three post-Katrina follow-ups, but 12 years after the hurricane, one in six still had symptoms indicative of probable post-traumatic stress disorder. The rate of non-specific psychological distress (PD) remained consistently higher in all three follow-ups, compared to the pre-disaster period. In full covariate-adjusted models, no sociodemographic variables predicted long-run combinations of PTSS and PD. However, 12 years later, exposure to hurricane-related traumatic events and pre-disaster PD significantly predicted co-occurring PTSS and PD. Hurricane-related housing damage predicted PTSS in earlier follow-ups, but no longer predicted PTSS in the long-term. Furthermore, hurricane-related traumatic events significantly differentiated the risk of having persistent PTSS, relative to recovering from PTSS. The results suggest that there is still a non-negligible group of survivors with continued need for recovery resources and that exposure to traumatic events is a primary predictor of adverse mental health more than a decade post-disaster.
Background: Rapid increases in drug overdose deaths in the United States since 2014 have been highly regionally stratified, with the largest increases occurring in the eastern and northeastern states. By contrast, many western states saw overdose deaths plateau. This paper shows how the differential influx of fentanyl and fentanyl ana- logues in the drug supply has reshaped the geography and demography of the overdose crisis in the United States.
Methods: Using all state lab drug seizures obtained by Freedom of Information Act request, I analyze the re- gionally distinctive presence of fentanyl in the US drug supply with descriptive plots and statistical models. Main analyses explore state-year overdose trends using two-way fixed effects ordinary least squares (OLS) regression and two-stage least squares regression (2SLS) instrumenting for fentanyl exposure with state-longitude times a linear trend.
Results: First, fentanyl exposure is highly correlated with geography and only weakly explained by overdose rates prior to 2014. States in the east (higher degrees longitude) are much more heavily affected. Second, fentanyl exposure exhibits a statistically significant and important effect on overdose mortality, with model- predicted deaths broadly consistent with official death statistics. Third, fentanyl exposure explains most of the variation in increased overdose mortality between 2011 and 2017. Consequently, the epicenter of the overdose crisis shifted towards the eastern United States over these years.
Conclusion: These findings shed light on the “third-wave” of the overdose epidemic, characterized by rapid and geographically disparate changes in drug supply that heighten the risk of overdose. Above all, they underscore the urgency of adopting evidence-based policies to combat addiction in light of the rapidly changing drug environment.
Conventional accounts of Donald Trump’s unexpected electoral victory stress idiosyncratic events and media celebrity because most observers assume this unusual candidate won without much organized support. However, considerable evidence suggests that the support of conservative organizational networks, including police unions such as the Fraternal Order of Police (FOP), propelled Trump to victory. The FOP is both a public-sector union and a conservative, mass-membership fraternal association that was courted by the Trump campaign at a time of politically charged debates about policing. Four years before, the FOP had refused to endorse Republican candidate Mitt Romney because he opposed public-sector unionism, which provided fruitful and rare variation in interest-group behavior across electoral cycles. Using a difference-in-differences approach, I find that FOP lodge density contributed to a significant swing in vote share from Romney to Trump. Moreover, survey evidence indicates that police officers reported increased political engagement in 2016 versus 2012. Belying the notion that Trump lacked a “ground game,” this research suggests that he tapped into existing organizational networks, showing their enduring importance in electoral politics.
Why are some societies more unequal than others? The French revolutionaries believed unequal inheritances among siblings to be responsible for the strict hierarchies of the ancien régime. To achieve equality, the revolutionaries therefore enforced equal inheritance rights. Their goal was to empower women and to disenfranchise the noble class. But do equal inheritances succeed in leveling the societal playing field? We study Germany—a country with pronounced local‐level variation in inheritance customs—and find that municipalities that historically equally apportioned wealth, to this day, elect more women into political councils and have fewer aristocrats in the social elite. Using historic data, we point to two mechanisms: wealth equality and pro‐egalitarian preferences. In a final step, we also show that, counterintuitively, equitable inheritance customs positively predict income inequality. We interpret this finding to mean that equitable inheritances level the playing field by rewarding talent, not status.
John, Leslie K., Hayley Blunden, and Heidi Liu. 2019. “Shooting the Messenger.” Journal of Experimental Psychology: General 148 (4): 644–666. Abstract
Eleven experiments provide evidence that people have a tendency to “shoot the messenger,” deeming innocent bearers of bad news unlikeable. In a preregistered lab experiment, participants rated messengers who delivered bad news from a random drawing as relatively unlikeable (Study 1). A second set of studies points to the specificity of the effect: Study 2A shows that it is unique to the (innocent) messenger and not mere bystanders. Study 2B shows that it is distinct from merely receiving information that one disagrees with. We suggest that people’s tendency to deem bearers of bad news as unlikeable stems in part from their desire to make sense of chance processes. Consistent with this account, receiving bad news activates the desire to sense-make (Study 3A), and in turn, activating this desire enhances the tendency to dislike bearers of bad news (Study 3B). Next, stemming from the idea that unexpected outcomes heighten the desire to sense-make, Study 4 shows that when bad news is unexpected, messenger dislike is pronounced. Finally, consistent with the notion that people fulfill the desire to sense-make by attributing agency to entities adjacent to chance events, messenger dislike is correlated with the belief that the messenger had malevolent motives (Studies 5A, 5B, & 5C). Studies 6A & 6B go further, manipulating messenger motives independently from news valence to suggest its causal role in our process account: the tendency to dislike bearers of bad news is mitigated when recipients are made aware of the benevolence of the messenger’s motives.
Our study explores the arrest experiences of two generational cohorts—those entering adulthood on either side of a large shift in American policing. Using the National Longitudinal Survey of Youth (1979 and 1997), we find a stark increase in arrest odds among the later generation at every level of offending, suggesting a decoupling between contact with the justice system and criminal conduct. Furthermore, this decoupling became racially inflected. Blacks had a much higher probability of arrest at the start of the twenty-first century than both blacks of the generation prior and whites of the same generation. The criminal justice system, we argue, slipped from one in which arrest was low and strongly linked to offending to one where a substantial share of Americans experienced arrest without committing a crime.
Today, low-income people seeking resources from the federal government must often work through non-profit organizations. The purpose of this paper is to examine the constraints that the poor must face today to secure resources through non-profit organizations. This is a conceptual paper. The authors review cases of non-profit organizations providing federally supported resources to the poor across multiple sectors.The authors find that to accept government contracts serving the poor, nonprofit organizations must often engage in one or several practices: reject clients normally consistent with their mission, select clients based on likely outcomes, ignore problems in clients’ lives relevant to their predicament, or undermine client progress to manage funding requirements. To secure government-supported resources from nonprofits, the poor must often acquiesce to intrusions into one or more of the following: their privacy (disclosing sensitive information), their self-protection (renouncing legal rights), their identity (avowing a particular self-understanding) or their self-mastery (relinquishing authority over daily routines). The authors show that the nonprofits’ dual role as brokers, both liaisons transferring resources and representatives of the state, can complicate their relation to their clients and the predicament of the poor themselves; the authors suggest that two larger trends, toward increasing administrative accountability and demonstrating deservingness, are having both intended and unintended consequences for the ability of low-income individuals to gain access to publicly funded resources.
Angie M. Bautista-Chavez and Sarah E. James look at the constituency-building strategies of three politically conservative organizations designed to reach veterans, millennials, and Latinos. They show how these organizations vary their outreach tactics to align the target audience with the political right.
Median compensation in the U.S. has diverged starkly from labor productivity since 1973, and average compensation from productivity since 2000. In this paper, we ask: holding all else equal, to what extent does productivity growth translate into compensation growth for typical American workers? We regress median, average, and production/nonsupervisory compensation growth on productivity growth in various specifications, finding substantial evidence of linkage between productivity and compensation. Over 1973–2016, one percentage point higher productivity growth was associated with 0.7-1 percentage points higher median and average compensation growth and with 0.4-0.7 percentage points higher production/nonsupervisory compensation growth. Further, we do not find strong evidence of co-movement between productivity growth and either the labor share or the mean/median compensation ratio. Our results tend to militate against pure technology-based theories of the productivity-compensation divergence, which would suggest that periods of higher productivity growth should also be periods of higher productivity-pay divergence. They suggest that factors orthogonal to productivity have been acting to suppress typical compensation even as productivity growth has been acting to raise it, and that faster future productivity growth is likely to boost median and average compensation growth close to one-for-one
Sociological accounts of urban disinvestment processes rarely assess how landlords’ variable investment strategies may be facilitated or constrained by the legal environment. Nor do they typically examine how such factors might, in turn, affect housing conditions for city dwellers. Over the past two decades, the advent and diffusion of the limited liability company (LLC) has reshaped the legal landscape of rental ownership. Increasingly, rental properties are owned by business organizations that limit investor liability, rather than by individual landlords who own property in their own names. An analysis of administrative records and survey data from Milwaukee, Wisconsin, demonstrates that signs of housing disinvestment increase when properties transition from individual to LLC ownership. This increase is not explained by selection on property characteristics or by divergent pre-transfer trends. Results affirm that real estate investors are responsive to changes in the legal environment and that the protective structure of the LLC facilitates housing disinvestment in Milwaukee. Elaborating the role of real estate investors can deepen accounts of neighborhood change processes and help explain variation in local housing conditions. Ultimately, public policies that enable business operators to circumscribe or reallocate risk may generate unintended costs for consumers and the public.
A rich literature examines how information spreads through social networks to influence life opportunities. However, receiving information does not guarantee its use in decision making. This article analyzes information evaluation as a fundamental component of social network mobilization. The case of school choice, where the value of information may be more uncertain, brings this evaluative dimension to the forefront. Interviews with 55 parents in Boston show how parents selecting schools assess their social network ties as information sources, privileging information from those they perceive to have affinity and authority. These evaluative criteria map onto disparate networks to engender unequal mobilization of this information. The findings illuminate mechanisms sustaining inequality in social network mobilization and reorient scholars to consider processes underlying information use alongside information diffusion to attain a more complete understanding of how network resources are mobilized in action.
With the expansion of state surveillance and enforcement efforts in recent decades, a growing literature examines how those vulnerable to punitive state contact strategize to evade it. This article draws on in-depth interviews with eighty-three low-income mothers to consider whether and how concerns about Child Protective Services (CPS), a widespread presence in poor communities with the power to remove children from their parents, inform poor mothers’ institutional engagement. Mothers recognized CPS reports as a risk in interactions with healthcare, educational, and social service systems legally mandated to report suspected child abuse or neglect. Departing from findings on responses to policing and immigration enforcement, I find that CPS concerns rarely prompted mothers to avoid systems wholesale. Within their system participation, however, mothers engaged in a selective or constrained visibility, concealing their hardships, home life, and parenting behavior from potential reporters. As reporting systems serve as vital sources of support for disadvantaged families, mothers’ practices of information management, while perhaps protecting them from CPS reports, may preclude opportunities for assistance and reinforce a sense of constraint in families’ institutional interactions.
We use data on intergenerational social mobility by neighborhood to examine how social and physical environments beyond concentrated poverty predict children’s long-term well-being. First, we examine neighborhoods that are harsh on children’s development: those characterized by high levels of violence, incarceration, and lead exposure. Second, we examine potential supportive or offsetting mechanisms that promote children’s development, such as informal social control, cohesion among neighbors, and organizational participation. Census tract mobility estimates from linked income tax and Census records are merged with surveys and administrative records in Chicago. We find that exposure to neighborhood violence, incarceration, and lead combine to independently predict poor black boys’ later incarceration as adults and lower income rank relative to their parents, and poor black girls’ teenage motherhood. Features of neighborhood social organization matter less, but are selectively important. Results for poor whites also show that toxic environments independently predict lower social mobility, as do features of social organization, to a lesser extent. Overall, our measures contribute a 76% relative increase in explained variance for black male incarceration beyond that of concentrated poverty and other standard characteristics, an 18% increase for black male income rank (70% for whites), and a 17% increase for teenage motherhood of black girls (40% for whites).
After more than a century of convergence, the economic fortunes of rich and poor regions of the United States have diverged dramatically over the last 40 years. Roughly a third of the US population now lives in metropolitan areas that are substantially richer or poorer than the nation as a whole, almost three times the proportion that did in 1980. In this paper I use counterfactual simulations based on Census microdata to understand the dynamics of regional divergence. I first show that regional divergence has primarily resulted from the richest people and places pulling away from the rest of the country. I then estimate the relative contributions to regional divergence of two major socioeconomic trends of recent decades: the sorting of people across metro areas by income level and the national rise in income inequality. I show that the national rise in income inequality is sufficient on its own to account for more than half of the observed divergence across regions, while income sorting on its own accounts for less than a quarter. The major driver of regional economic divergence is national-level income dispersion that has exacerbated preexisting spatial inequalities.